Cognitive Load Theory: A Broader View on the Role of Memory in Learning and Education

Social and communicative not a prerequisite: Preverbal infants learn an abstract rule only from congruent audiovisual dynamic pitch-height patterns

Learning in the everyday environment often requires the flexible integration of relevant multisensory information. Previous research has demonstrated preverbal infants' capacity to extract an abstract rule from audiovisual temporal sequences matched in temporal synchrony. Interestingly, this capacity was recently reported to be modulated by crossmodal correspondence beyond spatiotemporal matching (e.g., consistent facial emotional expressions or articulatory mouth movements matched with sound). To investigate whether such modulatory influence applies to non-social and non-communicative stimuli, we conducted a critical test using audiovisual stimuli free of social information: visually upward (and downward) moving objects paired with a congruent tone of ascending or incongruent (descending) pitch. East Asian infants (8-10 months old) from a metropolitan area in Asia demonstrated successful abstract rule learning in the congruent audiovisual condition and demonstrated weaker learning in the incongruent condition. This implies that preverbal infants use crossmodal dynamic pitch-height correspondence to integrate multisensory information before rule extraction. This result confirms that preverbal infants are ready to use non-social non-communicative information in serving cognitive functions such as rule extraction in a multisensory context.

Reasoning More Efficiently with Primary Knowledge Despite Extraneous Cognitive Load

Geary's evolutionary approach in educational psychology differentiates between primary (low cognitive costs and motivational advantage) and secondary knowledge (high cognitive costs and no motivational benefit). Although these features have been well demonstrated in previous work, the underlying mechanisms remain unclear. To investigate it, in a reasoning task, the present study varies (i) the content of the problems (primary knowledge vs. secondary; e.g., food vs. grammar rules), (ii) the intrinsic cognitive load (conflict or non-conflict syllogism, the former requiring more cognitive resources to be properly processed than the latter) and (iii) the extraneous cognitive load (via a Dot Memory Task with three modalities: low, medium and high cognitive load). Analyses assessed the influence of these variables on performance, problem solving speed and perceived cognitive load. Results confirmed the positive impact of primary knowledge on efficiency, particularly when intrinsic cognitive load was high. Surprisingly, the extraneous cognitive load did not influence the performance in secondary knowledge content but that in primary knowledge content: the higher the additional load was, the better the performance was, only for primary knowledge and especially for syllogisms with high intrinsic load. Findings support evolutionary theory as secondary knowledge would overload cognitive resources, preventing participants from allocating sufficient resources to solve problems. Primary knowledge would allow participants to process the additional load and to increase their performance despite this. This study also raises the hypothesis that a minimum cognitive load is necessary for participants to be invested in the task.

Biological evolution and human cognition are analogous information processing systems

The mechanisms that govern biological evolution and human cognition are analogous, as both follow the same principles of natural information processing systems. In this article, we describe the following five principles that provide an analogy between biological evolution and human cognition: (a) Randomness as Genesis Principle and (b) Borrowing and Reorganizing Principle, which indicate how natural information processing systems obtain information; (c) Narrow Limits of Change Principle and (d) Information Store Principle, which indicate how information is processed and stored; and (e) Environmental Organizing and Linking Principle, which indicate how stored information is used to generate actions appropriate to an environment. In human cognition, these analogs only apply to cognitive processes associated with biologically secondary knowledge, the knowledge typically taught in educational institutions. Based on these five principles, cognitive load theory researchers have provided diverse prescriptions to optimize instructional activities and materials. We conclude by discussing general instructional implications and future research directions based on this analogy.

The impact of a speaker's voice quality on auditory perception and cognition: a behavioral and subjective approach

Introduction

Our voice is key for conveying information and knowledge to others during verbal communication. However, those who heavily depend on their voice, such as teachers and university professors, often develop voice problems, signaled by hoarseness. The aim of this study was to investigate the effect of hoarseness on listeners' memory for auditory-verbal information, listening effort, and listening impression.

Methods

Forty-eight normally hearing adults performed two memory tasks that were auditorily presented in varied voice quality (typical vs. hoarse). The tasks were Heard Text Recall, as part of a dual-task paradigm, and auditory Verbal Serial Recall (aVSR). Participants also completed a listening impression questionnaire for both voice qualities. Behavioral measures of memory for auditory-verbal information and listening effort were performance and response time. Subjective measures of listening effort and other aspects of listening impression were questionnaire rating scores.

Results

Results showed that, except for the aVSR, behavioral outcomes did not vary with the speaker's voice quality. Regarding the aVSR, we found a significant interaction between voice quality and trial, indicating that participants' recall performance dropped in the beginning of the task in the hoarse-voice condition but not in the typical-voice condition, and then increased again toward the end. Results from the listening impression questionnaire showed that listening to the hoarse voice resulted in significantly increased perceived listening effort, greater annoyance and poorer self-reported performance.

Discussion

These findings suggest that hoarseness can, at least subjectively, compromise effective listening. Vocal health may be particularly important in the educational context, where listening and learning are closely linked.

Examining Factors Influencing Cognitive Load of Computer Programmers

In this study, the factors influencing the cognitive load of computer programmers during the perception of different code tasks were investigated. The eye movement features of computer programmers were used to provide a significant relationship between the perceptual processes of the sample codes and cognitive load. Thanks to the relationship, the influence of various personal characteristics of programmers on cognitive load was examined. Various personal parameters such as programming experience, age, native language, and programming frequency were used in the study. The study was performed on the Eye Movements in Programming (EMIP) dataset containing 216 programmers with different characteristics. Eye movement information recorded during two different code comprehension tasks was decomposed into sub-information, such as pupil movement speed and diameter change. Rapid changes in eye movement signals were adaptively detected using the z-score peak detection algorithm. Regarding the cognitive load calculations, canonical correlation analysis was used to build a statistically significant and efficient mathematical model connecting the extracted eye movement features and the different parameters of the programmers, and the results were statistically significant. As a result of the analysis, the factors affecting the cognitive load of computer programmers for the related database were converted into percentages, and it was seen that linguistic distance is an essential factor in the cognitive load of programmers and the effect of gender on cognitive load is quite limited.

Targeting Patients' Cognitive Load for Telehealth Video Visits Through Student-Delivered Helping Sessions at a United States Federally Qualified Health Center: Equity-Focused, Mixed Methods Pilot Intervention Study

BACKGROUND

The task complexity involved in connecting to telehealth video visits may disproportionately impact health care access in populations already experiencing inequities. Human intermediaries can be a strategy for addressing health care access disparities by acting as technology helpers to reduce the cognitive load demands required to learn and use patient-facing telehealth technologies.

OBJECTIVE

We conducted a cognitive load theory-informed pilot intervention involving warm accompaniment telehealth helping sessions with patients at a Federally Qualified Health Center (FQHC). We demonstrate how to design and report recruitment methods, reach, delivery process, and the preliminary impact of a novel equity-focused intervention.

METHODS

Early into the COVID-19 pandemic a telehealth helping session was offered to patients at FQHC via phone. Graduate students led the sessions on conducting a telehealth video test run or helping with patient portal log-in. They systematically recorded their recruitment efforts, intervention observations, and daily reflection notes. Following the intervention, we asked the intervention participants to participate in an interview and all patients who had telehealth visits during and 4 weeks before and after the intervention period to complete a survey. Electronic health records were reviewed to assess telehealth visit format changes. Descriptive and inferential statistical analyses of the recruitment records, electronic health record data, and surveys were performed. Through integrative analysis, we developed process-related themes and recommendations for future equity-focused telehealth interventions.

RESULTS

Of the 239 eligible patients, 34 (14.2%) completed the intervention and 3 (1.2%) completed subsequent interviews. The intervention participants who completed the survey (n=15) had lower education and less technological experience than the nonintervention survey participants (n=113). We identified 3 helping strategies for cognitive load reduction: providing step-by-step guidance for configuring and learning, building rapport to create confidence while problem-solving, and being on the same page to counter informational distractions. Intervention participants reported increased understanding but found that learning the video visit software was more difficult than nonintervention participants. A comparison of visit experiences did not find differences in difficulty (cognitive load measure) using telehealth-related technologies, changes to visit modality, or reported technical problems during the visit. However, the intervention participants were significantly less satisfied with the video visits.

CONCLUSIONS

Although a limited number of people participated in the intervention, it may have reached individuals more likely to need technology assistance. We postulate that significant differences between intervention and nonintervention participants were rooted in baseline differences between the groups' education level, technology experience, and technology use frequency; however, small sample sizes limit conclusions. The barriers encountered during the intervention suggest that patients at FQHC may require both improved access to web-based technologies and human intermediary support to make telehealth video visits feasible. Future large, randomized, equity-focused studies should investigate blended strategies to facilitate video visit access.

Primary vs. secondary knowledge contents in reasoning: Motivated and efficient vs. overburdened

Primary knowledge is the knowledge for which our cognitive architecture has evolved so that we acquire it quickly and effortlessly. We are intrinsically motivated to process it. Secondary knowledge is the knowledge for which our cognitive architecture has not had enough time to evolve: it requires time, cognitive resources and is hardly motivating. This study proposed to test these evolutionary characteristics using the experimental paradigm of logical reasoning. We conducted five experiments (n = 720) varying (i) the content of syllogisms (primary or secondary knowledge), (ii) the presentation order of the knowledge types, (iii) the added extrinsic cognitive load, and (iv) the type of syllogism. Results showed that primary knowledge increased performance, emotional and cognitive investment and decreased perceived cognitive load. Second, presenting primary knowledge first would encourage participants to be motivated throughout the task, while presenting secondary knowledge first would undermine their motivation. Third, secondary knowledge seemed to lead to a feeling of conflict that consumed cognitive resources. All together, these results suggested that primary knowledge should be taken into account and not left aside because it is something "already learned".

Is Instructional Scaffolding a Better Strategy for Teaching Writing to EFL Learners? A Functional MRI Study in Healthy Young Adults

To test the scaffolding theory when applied to the teaching and learning of writing English as a foreign language, this cross-sectional study was conducted to collect physiological data. A total of 53 participants were randomly assigned into two groups, and brain activity was investigated during a guided-writing task using storytelling pictures. The writing task was further divided into four parts using graded levels of difficulty. The experimental group performed tasks in sequence from easy to difficult, whereas the comparison group performed the tasks at random. Outcomes included handwriting assessments and fMRI measurements. Writing outcome assessments were analyzed using SPSS, and scanned images were analyzed using Statistical Parametric Mapping (SPM) software. The results revealed a positive learning effect associated with scaffolding instruction. The experimental group performed better during the writing tasks, and the fMRI images showed less intense and weaker reactions in the language processing region than were observed in the comparison group. The fMRI results also presented the experimental group with reduced motor and cognitive functions when writing in English. This study provides insight regarding brain activity during writing tasks in humans and may have implications for English-language instruction.

Neurocognitive Changes in Spinocerebellar Ataxia Type 3: A Systematic Review with a Narrative Design

Spinocerebellar ataxia type 3 (SCA3), the commonest dominantly inherited ataxia worldwide, is characterized by disruption in the cerebellar-cerebral and striatal-cortical networks. Findings on SCA3-associated cognitive impairments are mixed. The classification models, tests and scoring systems used, language, culture, ataxia severity, and depressive symptoms are all potential confounders in neuropsychological assessments and may have contributed to the heterogeneity of the neurocognitive profile of SCA3. We conducted a systematic review of studies evaluating neurocognitive function in SCA3 patients. Of 1304 articles identified, 15 articles met the eligibility criteria. All articles were of excellent quality according to the National Institutes of Health quality assessment tool for case-control studies. In line with the disrupted cerebellar-cerebral and striatal-cortical networks in SCA3, this systematic review found that the neurocognitive profile of SCA3 is characterized by a core impairment of executive function that affects processes such as nonverbal reasoning, executive aspects of language, and recall. Conversely, neurocognitive domains such as general intelligence, verbal reasoning, semantic aspect of language, attention/processing speed, recognition, and visuospatial perception and construction are relatively preserved. This review highlights the importance of evaluating neurocognitive function in SCA3 patients. Considering the negative impact of cognitive and affective impairment on quality of life, this review points to the profound impairments that existing or future treatments should prioritize.

Which Tools in Multimedia Are Best for Learning Outcomes? A Study Grounded in Cognitive Load Structures

The main objective of this study is to investigate the importance of three compositions in multimedia for learning outcomes (LOs) in relation to individual differences in short-term memory (STM) capacity. The study is based on a survey of 378 individuals at the bachelor level (military officers, teachers, and psychology students). The LOs of three different multimedia compositions (means) were tested. This applied to individuals with low, medium, and high STM capacity. The results show that the successive presentation (Type II) of learning materials through multiple representation forms/channels (speech, pictures, and screen text/labels) provides a better LO than just speech (Type I) and simultaneous presentation (Type III). Overall, visual and verbal channel capacities did not contribute to the LO in any of the three tools tested, but some specific STM capacity types or substructures (visual and verbal progressive capacities) and non-verbal (RAPM) types have significance, particularly in exploiting successive presentation (Type II) for learning. Although the tools used in the multimedia educational material had a low cognitive load, the individuals with low capacity learned relatively less than the individuals with higher capacity. A symbolic form of expression was introduced concerning the relationship between cognitive load structure (CLS) and LOs through various tools in multimedia as an aid in the theoretical and empirical analyses. This is referred to as the CLS-LO formula. The main assumption of this study, based on previous empirical and theoretical ones, is that the relationship between CLS and LO is expressed with the following CLS-LO formula: CLSTypeIII>CLSTypeII>CLSTypeI→LOTypeIII>LOTypeI>LOTypeII. Based on this study, the relationship became: CLSTypeIII>CLSTypeI>CLSTypeII→LOTypeII>LOTypeI=LOTypeIII. This basic research study is primarily a contribution to understanding underlying cognitive processes in STM and their importance for learning in multimodal forms compared with analogue text. The findings will also be relevant as a basis for performance analysis and decision-making under high information pressure, risk, and unpredictable conditions.

Understanding Motor Skill Learning as Related to Dentistry

Learning dental procedures is a complex task involving the development of fine motor skills. The reported use of theories and/or evidence for designing learning activities to develop the fine motor skills needed for dental practice is limited. The aim of this review is to explore the available body of knowledge related to learning motor skills relevant to dentistry. Evidence from studies investigating motor skill learning highlights the negative impact of self-focus and self-regulation on learning outcomes, particularly during the early stages of learning. The development of activities and schedules that enable novices to demonstrate characteristics similar to experts, without the reported long period of 'deliberate practice', is clearly of value. Outcomes of learning implicitly are important in dentistry because working under stressful conditions is common, either during undergraduate study or in practice. It is suggested that learning implicitly in the simulation stage can reduce disrupted performance when transitioning to clinical settings. Therefore, further investigation of effective methods for learning dental fine motor skills is indicated, using approaches that result in robust performance, even under stressful conditions.

Comorbid Learning Difficulties in Reading and Mathematics: The Role of Intelligence and In-Class Attentive Behavior

The goal was to identify the domain-general cognitive abilities and academic attitudes that are common and unique to reading and mathematics learning difficulties that in turn will have implications for intervention development. Across seventh and eighth grade, 315 (155 boys) adolescents (M age = 12.75 years) were administered intelligence, verbal short-term and working memory, and visuospatial memory, attention, and ability measures, along with measures of English and mathematics attitudes and mathematics anxiety. Teachers reported on students' in-class attentive behavior. A combination of Bayesian and multi-level models revealed that intelligence and in-class attentive behavior were common predictors of reading accuracy, reading fluency, and mathematics achievement. Verbal short-term memory was more critical for reading accuracy and fluency, whereas spatial ability and mathematics self-efficacy were more critical for mathematics achievement. The combination of intelligence and in-class attentive behavior discriminated typically achieving students from students with comorbid (D = 2.44) or mathematics (D = 1.59) learning difficulties, whereas intelligence, visuospatial attention, and verbal short-term memory discriminated typically achieving students from students with reading disability (D = 1.08). The combination of in-class attentive behavior, verbal short-term memory, and mathematics self-efficacy discriminated students with mathematics difficulties from their peers with reading difficulties (D = 1.16). Given the consistent importance of in-class attentive behavior, we conducted post hoc follow-up analyses. The results suggested that students with poor in-class attentive behavior were disengaging from academic learning which in turn contributed to their risk of learning difficulties.

Boys' advantage on the fractions number line is mediated by visuospatial attention: Evidence for a parietal-spatial contribution to number line learning

The study tested the hypotheses that boys will have an advantage learning the fractions number line and this advantage will be mediated by spatial abilities. Fractions number line and, as a contrast, fractions arithmetic performance were assessed for 342 adolescents, as was their intelligence, working memory, and various spatial abilities. Boys showed smaller placement errors on the fractions number line (d = -0.22) and correctly solved more fractions arithmetic problems (d = 0.23) than girls. Working memory and intelligence predicted performance on both fractions measures, and a measure of visuospatial attention uniquely predicted number line performance and fully mediated the sex difference. Visuospatial working memory uniquely predicted fractions arithmetic performance and fully mediated the sex difference. The results help to clarify the nuanced relations between spatial abilities and formal mathematics learning and the sex differences that often emerge in mathematical domains that have a visuospatial component.

Pupil diameter differentiates expertise in dental radiography visual search

Expert behavior is characterized by rapid information processing abilities, dependent on more structured schemata in long-term memory designated for their domain-specific tasks. From this understanding, expertise can effectively reduce cognitive load on a domain-specific task. However, certain tasks could still evoke different gradations of load even for an expert, e.g., when having to detect subtle anomalies in dental radiographs. Our aim was to measure pupil diameter response to anomalies of varying levels of difficulty in expert and student dentists’ visual examination of panoramic radiographs. We found that students’ pupil diameter dilated significantly from baseline compared to experts, but anomaly difficulty had no effect on pupillary response. In contrast, experts’ pupil diameter responded to varying levels of anomaly difficulty, where more difficult anomalies evoked greater pupil dilation from baseline. Experts thus showed proportional pupillary response indicative of increasing cognitive load with increasingly difficult anomalies, whereas students showed pupillary response indicative of higher cognitive load for all anomalies when compared to experts.

Cognitive-Motor Dual Task Interference Effects on Declarative Memory: A Theory-Based Review

Bouts of exercise performed either prior to or immediately following study periods enhance encoding and learning. Empirical evidence supporting the benefits of interventions that simultaneously pair physical activity with material to be learned is not conclusive, however. A narrative, theory-based review of dual-task experiments evaluated studies in terms of arousal theories, attention theories, cognitive-energetic theories, and entrainment theories. The pattern of the results of these studies suggests that cognitive-motor interference can either impair or enhance memory of semantic information and the manner in which physical activity impacts working memory within executive processing appears to explain disparate outcomes. The integration and timing of physical movements in concert with the type of information to be encoded and remembered appears to be a critical requirement for learning. These observations have implications for the role of physical activity in education, rehabilitation, and gerontological settings.

Effects of insomnia symptoms and objective short sleep duration on memory performance in youths

Sleep quantity and quality are both important for optimal development and functioning during youth. Yet few studies have examined the effects of insomnia symptoms and objective short sleep duration on memory performance among adolescents and young adults. One-hundred and ninety participants (female: 61.6%) aged from 12 to 24 years completed this study. All participants underwent a clinical interview, a 7-day actigraphic assessment, a battery of self-report questionnaires and cognitive tests to assess working memory and episodic memory. Insomnia symptoms were defined as a score ≥ 9 on the Insomnia Severity Index, and objective short sleep duration was defined as average total sleep time less than 7 hr for those aged 12-17 years, and 6 hr for those aged 18 years and above as assessed by actigraphy. Insomnia symptoms were significantly associated with worse self-perceived memory (p < .05) and poorer performance on the digit span task (p < .01), but not the dual N-back task and verbal learning task. There was no significant difference in any of the memory measures between participants with objective short sleep duration and their counterparts. No interaction effect was found between insomnia and short sleep duration on any of the objective memory outcomes. Insomnia symptoms, but not objective short sleep duration, were associated with poorer subjective memory and objective working memory performance in youths. Further studies are needed to investigate the underlying mechanisms linking insomnia and memory impairments, and to delineate the long-term impacts of insomnia on other aspects of neurocognitive functioning in youth.

A comparison of methods used for inducing mental fatigue in performance research: individualised, dual-task and short duration cognitive tests are most effective

Despite research indicating the negative impact that mental fatigue has on physical and cognitive performance, whether this is a result of mental fatigue or a state of under-arousal remains unclear. The current research aimed to explore the effectiveness of the methods being used to induce mental fatigue. Twelve participants attended six sessions in which two cognitive tests, the AX-continuous performance test (AX-CPT) and the TloadDback test, were compared for their effectiveness in inducing mental fatigue. Both tests were set at a standard processing speed (1.2 ms) for two conditions, and a further condition involved the individualisation of the TloadDback test. Participants presented significantly higher physiological and psychological arousal (p < 0.05) in the individualised dual-task test compared to the AX-CPT. The individualised TloadDback test is a more effective method of inducing mental fatigue compared to the AX-CPT, as it sustains physiological arousal whilst inducing measurable reductions in mental resources. Practitioner summary: Mental fatigue negatively impacts physical and cognitive performance. It is unclear whether the current methods being used to induce mental fatigue are effective. This study compared different methods and confirmed that short, individualised and dual-task tests are most effective for inducing mental fatigue whilst maintaining arousal.

Interactive whiteboard use in clinical reasoning sessions to teach diagnostic test ordering and interpretation to undergraduate medical students

BACKGROUND

Over-testing of patients is a significant problem in clinical medicine that can be tackled by education. Clinical reasoning learning (CRL) is a potentially relevant method for teaching test ordering and interpretation. The feasibility might be improved by using an interactive whiteboard (IWB) during the CRL sessions to enhance student perceptions and behaviours around diagnostic tests. Overall, IWB/CRL could improve their skills.

METHODS

Third-year undergraduate medical students enrolled in a vertically integrated curriculum were randomized into two groups before clinical placement in either a respiratory disease or respiratory physiology unit: IWB-based CRL plus clinical mentoring (IWB/CRL + CM: n = 40) or clinical mentoring only (CM-only: n = 40). Feasibility and learning outcomes were assessed. In addition, feedback via questionnaire of the IWB students and their classmates (n = 233) was compared.

RESULTS

Analyses of the IWB/CRL sessions (n = 40, 27 paperboards) revealed that they met validated learning objectives. Students perceived IWB as useful and easy to use. After the IWB/CRL + CM sessions, students mentioned more hypothesis-based indications in a test ordering file (p <  0.001) and looked for more nonclinical signs directly on raw data tests (p <  0.01) compared with students in the CM-only group. Last, among students who attended pre- and post-assessments (n = 23), the number of diagnostic tests ordered did not change in the IWB/CRL + CM group (+ 7%; p = N.S), whereas it increased among CM-only students (+ 30%; p <  0.001). Test interpretability increased significantly in the IWB/CRL + CM group (from 4.7 to 37.2%; p <  0.01) but not significantly in the CM-only group (from 2.4 to 9.8%; p = 0.36).

CONCLUSIONS

Integrating IWB into CRL sessions is feasible to teach test ordering and interpretation to undergraduate students. Moreover, student feedback and prospective assessment suggested a positive impact of IWB/CRL sessions on students' learning.

Continuous Evaluation of the Learning Process of Algebra Through a Semi-Automated Tool

Personalized education is an issue that is being considered in the development of automated tools. Personalized education refers to the fact that students' characteristics must be considered to determine the type of teaching or instructional design that must be provided to him/her. Within the area of intelligent tutorial systems (STI), student characteristics are handled within the student's module and usually refer to the student's skills, learning styles and prior knowledge of the subject of interest. The latter is closely related to the need to constantly assess the student, which is a process that is not easy to perform manually. However, several public schools in Mexico there is not the infrastructure necessary to be able to use automated tools, in each of the classrooms. This article is a proposal for a semi-automated tool for constant assessment.

Thrive or overload? The effect of task complexity on novices' simulation-based learning

CONTEXT

Fidelity is widely viewed as an important element of simulation instructional design based on its purported relationship with transfer of learning. However, higher levels of fidelity may increase task complexity to a point at which novices' cognitive resources become overloaded.

OBJECTIVES

In this experiment, we investigate the effects of variations in task complexity on novices' cognitive load and learning during simulation-based procedural skills training.

METHODS

Thirty-eight medical students were randomly assigned to simulation training on a simple or complex lumbar puncture (LP) task. Participants completed four practice trials on this task (skill acquisition). After 10 days of rest, all participants completed one additional trial on their assigned task (retention) and one trial on a 'very complex' simulation designed to be similar to the complex task (transfer). We assessed LP performance and cognitive load on each trial using multiple measures.

RESULTS

In both groups, LP performance improved significantly during skill acquisition (p ≤ 0.047, f = 0.29-0.96) and was maintained at retention. The simple task group demonstrated superior performance compared with the complex task group throughout these phases (p ≤ 0.002, d = 1.13-2.31). Cognitive load declined significantly in the simple task group (p < 0.009, f = 0.48-0.76), but not in the complex task group during skill acquisition, and remained lower at retention (p ≤ 0.024, d = 0.78-1.39). Between retention and transfer, LP performance declined and cognitive load increased in the simple task group, whereas both remained stable in the complex task group. At transfer, no group differences were observed in LP performance and cognitive load, except that the simple task group made significantly fewer breaches of sterility (p = 0.023, d = 0.80).

CONCLUSIONS

Reduced task complexity was associated with superior LP performance and lower cognitive load during skill acquisition and retention, but mixed results on transfer to a more complex task. These results indicate that task complexity is an important factor that may mediate (via cognitive overload) the relationship between instructional design elements (e.g. fidelity) and simulation-based learning outcomes.

Writing on the board as students' preferred teaching modality in a physiology course

The introduction of PowerPoint presentation software has generated a paradigm shift in the delivery of lectures. PowerPoint has now almost entirely replaced chalkboard or whiteboard teaching at the undergraduate and graduate levels. This study investigated whether undergraduate biology students preferred to have lectures delivered by PowerPoint or written on the board as well as the reasons behind their preference. Two upper-division physiology courses were surveyed over a period of 7 yr. A total of 1,905 students (86.7%) indicated they preferred lectures delivered by "writing on the board" compared to 291 students (13.3%) who preferred PowerPoint. Common themes drawn from explanations reported by students in favor of writing on the board included: 1) more appropriate pace, 2) facilitation of note taking, and 3) greater alertness and attention. Common themes in favor of PowerPoint included 1) increased convenience, 2) focus on listening, and 3) more accurate and readable notes. Based on the students' very strong preference for writing on the board and the themes supporting that preference, we recommend that instructors incorporate elements of the writing on the board delivery style into whatever teaching modality is used. If instructors plan to use PowerPoint, the presentation should be paced, constructed, and delivered to provide the benefits of lectures written on the board. The advantages of writing on the board can be also incorporated into instruction intended to occur outside the classroom, such as animated narrated videos as part of the flipped classroom approach.